University of Colorado School of Medicine, Aurora, CO, USA.
Subst Abus. 2023 Jan-Apr;44(1):17-23. doi: 10.1177/08897077231165619. Epub 2023 Apr 26.
The opioid misuse epidemic is a serious public health crisis. Opioid-involved deaths continue to rise and the potency of illicitly manufactured synthetic opioids has increased, creating challenges for the healthcare system to provide multifaceted specialized care. Elements of the regulation around buprenorphine, 1 of 3 drugs approved to treat opioid use disorder (OUD), constrain treatment options for patients and providers alike. Updates to this regulatory framework, particularly around dosing and access to care, would enable providers to better treat the changing landscape of opioid misuse. Specific actions to this end are to: (1) Increase buprenorphine dosing flexibility based on FDA labeling which drives payor policies; (2) Restrict local government and institutional impositions of arbitrary access and dosing limits for buprenorphine; and (3) Liberalize buprenorphine initiation and maintenance via telemedicine for OUD.
阿片类药物滥用危机是一场严重的公共卫生危机。阿片类药物相关死亡人数持续上升，非法制造的合成阿片类药物的效力也有所增加，这给医疗保健系统提供多方面的专业治疗带来了挑战。受管制的丁丙诺啡是 3 种获准用于治疗阿片类药物使用障碍 (OUD) 的药物之一，它的管理要素限制了患者和提供者的治疗选择。更新这一监管框架，特别是在剂量和获得治疗方面，将使提供者能够更好地应对阿片类药物滥用的变化局面。为此采取的具体措施包括：(1) 根据食品和药物管理局的标签，增加丁丙诺啡的剂量灵活性，这推动了支付者的政策；(2) 限制地方政府和机构对丁丙诺啡的任意获取和剂量限制的限制；(3) 通过远程医疗使 OUD 的丁丙诺啡初始治疗和维持治疗自由化。
